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Permission for Treatment if Cost exceeds 2.5 Lac

Government of West Bengal
Finance Department
Audit Branch
Medical Cell

No. 71(80)-F(MED)-WB Dated: 09.10.2013.

From: Shri Samiran Pal, W.B.C.S. (Exe.),
Special Secretary to the
Government of West Bengal

To: The C.E.O./ Medical Superintendent,
…………………………………
…………………………………

Sub: Request to furnish treatment related papers at the time of seeking permission from the West Bengal Health Scheme Authority.

Sir,

With due respect, I am directed to draw your kind attention to the fact that obtaining permission from the West Bengal Health Scheme Authority is mandatory on the part of the H.C.O.s empanelled under the West Bengal Health Scheme, 2008 for performing certain procedures, e.g. implantation of dual chamber pacemaker, PTCA with more than two stents or more than one drug eluting stents, human organ transplantation, etc. or in case of conservative treatment where the cost of treatment exceeds Rs. 2.5 Lac vide Clause-8.16, 8.17 and 8.18 of the agreement signed between the H.C.O.s and West Bengal Health Scheme Authority. However, it is frequently observed that permission is sought for by the empanelled H.C.O.s without furnishing relevant papers related to the treatment. Such cases are placed before the West Bengal Health Scheme Authority and the Authority seeks for furnishing treatment related papers required for arriving at any decision. This is causing serious delay in the treatment process.

Accordingly, I am directed to request you to furnish the following papers at the time of seeking permission from West Bengal Health Scheme Authority:-

1. For seeking permission for treatment with the cost exceeding Rs. 2.5 Lac:-

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Comments

It is not clear if one having a dual chamber pacemaker implanted prior to the existence of WBHS 2008 will be required prior permission for replacement of the pacemaker or its leads , if necessary. Leads do not come under free replacement guarantee. Clarification needed.